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Skyline, Kvh Consolidate To Create County-Wide Ambulance Service

Effective Aug. 26

By BEN MITCHELL

The Enterprise

Divesting control of its ambulance service has been on Skyline Hospital's budget wishlist for months and come Aug. 26, the commissioners for the financially struggling hospital will get at least part of what they've wanted.

Last week, Skyline announced it had entered into an $870,000, one-year contract with Hadassah Management Systems, LLC, of Goldendale, to manage its ambulance service.

"Effective August 26, 2012, the ambulance services of both Klickitat Valley Health and Skyline Hospital will combine operations and HMS will take over day to day operation of both services," stated an Aug. 7 press release from Skyline.

Mark Bryan, owner of HMS, says he's been a medic for 35 years and managed KVH's ambulance service from 1984 to 1998. He described HMS as a "personnel management company" and said the transition will be largely unnoticeable.

"The only difference is that [ambulance personnel] will show up in different colored shirts," Bryan noted.

The ambulances and the uniforms of the crews manning them will display the name of the hospital they're affiliated with, as well as the letters "HMS." However, the impacts for Skyline are more than superficial.

As a result of the change, Skyline Hospital CEO Mike Madden stated that the hospital's Dallesport ambulance service would return to 24/7 coverage on Aug. 26, after being reduced to 14/7 coverage this spring. The current ambulances at KVH and Skyline will continue to be staffed 24/7 as well as a standby crew and ambulance in Goldendale.

That's not the only benefit of the deal. Madden explained that providing an ambulance service has always been the hospital's biggest expense, responsible for an annual $450,000 loss that has increased due to rising costs. Under its contract with HMS, Madden estimated that the number would be reduced to about $300,000 per year. The cost savings derive from the fact that ambulances managed by an independent or municipal operator receive a higher rate of reimbursement from Medicare than Critical Access Hospitals (such as Skyline) do. Madden noted that savings will also come from the ability to pool resources on purchasing drugs, supplies and fuel for the ambulances.

Bryan noted that all but one of the 13 ambulance crew members have elected to work under HMS and said his employees will "essentially be getting the same wages" as the did when employed by Skyline. Madden acknowledged, however that due to the transition, the manager position of Skyline's ambulance service was cut.

Both Madden and KVH CEO John White mentioned that while public rural hospital districts are required by law to submit requests for proposals when it comes to public works projects, they are not required to solicit bids for professional services. HMS has operated KVH's ambulance since 2010 and the contract with Skyline was awarded partly based on the desire to operate the county-wide ambulance service under one municipal provider. White, however, was quick to tout HMS and said service has been better than when KVH ran the ambulance.

"We've really had a great year with them," White said. "It's been a major improvement."

Although Skyline and KVH no longer manage the operation or the employees of the ambulances that serve the two hospitals, both the rolling stock (the actual ambulance vehicles) and all capital equipment are still owned by both entities.

Madden hopes that this will also change if Skyline gets the other item on its wishlist: the establishment of a county-wide Emergency Medical Services district to support and administer the county-wide ambulance service. The creation of the district would result in both hospitals transferring all their ambulance service assets over to the EMS district, which Madden said would be served by its own board of commissioners and can assess its own levies as a junior taxing district.

Skyline's current EMS levy is assessed at a rate of approximately 28 cents per $1,000 of assessed value. Madden said if the EMS district were to be created, it would likely need to run a replacement levy proposal once the current one expired.

"I would suspect that [the EMS district] could do it for more than 28 cents and less than 50 cents [per $1,000 of assessed value]," he speculated.

Madden explained that the only action needed to form the district would be a majority vote from the Klickitat County Commissioners. Both Madden and White said they plan on visiting community councils around the county to gauge the public's reaction before the proposal is put before the county commissioners. The timeline for the process is uncertain, but Madden noted the sooner the county-wide EMS district was created, the better.

"It would be great for Skyline if this were in place before the end of the year," he said.

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